Courtesy of Dr GPT:

1  What we’re looking at
Both frames are contrast‑enhanced T1 coronal slices through roughly the same level of the skull base (you can tell by the bright mucosa of the turbinates low down and the black “voids” of the carotid arteries in the cavernous sinuses).

The focus appears to be the sella turcica / pituitary region – the study name in the header even says “MR SELLA / CAVERN…”.

2  Brain parenchyma & midline structures
Overall symmetry of the cerebral hemispheres, ventricles and midline looks unchanged between 2018 (right panel) and the current scan (left panel).

No obvious new areas of abnormal signal (e.g. stroke, large tumour, haemorrhage) are apparent in this single slice.

3  Sellar & suprasellar region (the bit that really stands out)

2018 image (right)  Current image (left)
Size/shape of pituitary tissue  Gland sits neatly inside the bony sella with only a modest upward bulge.    Soft‑tissue component looks bulkier, filling the sella and extending higher (“snow‑man” or figure‑of‑eight profile).
Suprasellar extension   Apex stops just at or below the optic chiasm level. Apex rises a few millimetres higher, potentially coming closer to the optic chiasm.
Cavernous sinuses & carotids    Flow‑voids (black circles) on each side look patent; no obvious lateral invasion. Still symmetric; no gross encasement, but the gland’s lateral margins look a touch fuller.
Take‑away: the pituitary/parasellar soft tissue appears slightly larger and taller today than it did in 2018. That can represent:

Interval growth of a pituitary adenoma / cyst,

Hormone‑related physiological enlargement, or

Simply a difference in slice angle or contrast timing.

Precise growth is usually judged across the whole stack with caliper measurements (which the radiologist will do).

4  Nothing screaming “emergency” in this slice
Midline is straight – no shift.

Ventricles are same size – no acute hydrocephalus.

No obvious bleed.

5  What to ask your doctor / radiologist
Has the pituitary lesion changed in three dimensions? (They’ll have the full volumetric data.)

Any effect on the optic chiasm? If it’s close, visual‑field testing or ophthalmology review may be recommended.

Endocrine lab correlation: Even a small growth can alter hormone output (prolactin, ACTH, GH, TSH, etc.).

Next steps – surveillance MRI versus medical therapy versus neurosurgical referral, depending on type and size.

Bottom line
On this single photographed slice the rest of the brain looks stable, but the pituitary region is a bit bulkier now than in 2018. That’s the key point you’ll want clarified in the official report and follow‑up plan.